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The organization and financing of end-stage renal disease treatment in Japan

  • Shunichi Fukuhara
  • Chikao Yamazaki
  • Yasuaki Hayashino
  • Takahiro Higashi
  • Margaret A. Eichleay
  • Takashi Akiba
  • Tadao Akizawa
  • Akira Saito
  • Friedrich K. Port
  • Kiyoshi Kurokawa
Article

Abstract

End-stage renal disease (ESRD) affects 230,000 Japanese, with about 36,000 cases diagnosed each year. Recent increases in ESRD incidence are attributed mainly to increases in diabetes and a rapidly aging population. Renal transplantation is rare in Japan. In private dialysis clinics, the majority of treatment costs are paid as fixed fees per session and the rest are fee for service. Payments for hospital-based dialysis are either fee-for-service or diagnosis-related. Dialysis is widely available, but reimbursement rates have recently been reduced. Clinical outcomes of dialysis are better in Japan than in other countries, but this may change given recent ESRD cost containment policies.

Keywords

End-stage renal disease Dialysis Health care financing Medical costs Reimbursement Japan 

JEL Classifications

I10 I11 I12 I18 

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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Shunichi Fukuhara
    • 1
    • 2
  • Chikao Yamazaki
    • 3
  • Yasuaki Hayashino
    • 1
  • Takahiro Higashi
    • 1
  • Margaret A. Eichleay
    • 4
  • Takashi Akiba
    • 5
  • Tadao Akizawa
    • 6
  • Akira Saito
    • 7
  • Friedrich K. Port
    • 4
  • Kiyoshi Kurokawa
    • 8
  1. 1.Department of Epidemiology and Healthcare ResearchKyoto University Graduate School of Medicine and Public HealthKyotoJapan
  2. 2.Institute for Health Outcomes and Process Evaluation ResearchTokyoJapan
  3. 3.Masuko Memorial HospitalNagoyaJapan
  4. 4.Arbor Research Collaborative for HealthAnn ArborUSA
  5. 5.Tokyo Women’s Medical CollegeTokyoJapan
  6. 6.Showa University School of MedicineTokyoJapan
  7. 7.Tokai University School of MedicineIseharaJapan
  8. 8.National Graduate Institute of Policy Study and Health Policy InstituteTokyoJapan

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